Abstract
Background: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and menstrual disturbance. Independent of the presence of obesity, these women are frequently insulin resistant and, therefore, hyperinsulinemia, which appears to play a pathogenic role in the disease. Administration of insulin-sensitizing drugs, such as metformin and rosiglitazone, increase ovulation rates and decrease circulating androgens. Objective: The aim of this study was to evaluate the effects of rosiglitazone with or without clomiphene citrate (CC) on ovulation in patients with PCOS. Methods: A randomized, prospective study was carried out on 30 women with PCOS. Subjects in group 1 (n = 15) received rosiglitazone 4 mg BID and subjects in group 2 (n = 15) received rosiglitazone 4 mg BID with CC 50 mg on cycle days 5–9. The duration of treatment was 3 months. Main Outcome Measures: The primary outcome was ovulation as defined by serum progesterone >5 ng/mL on day 24 of the cycle. Secondary outcomes were pregnancy and changes in serum luteinizing hormone (LH), LH follicle-stimulating hormone (FSH) ratio, fasting serum glucose, testosterone, and lipid profile levels. Results: In this study, rosiglitazone was effective in inducing ovulation of 6 of 15 patients (40%) in group 1 and 10 of 15 (66.67%) in group 2. Three (3) patients in group 1 (20%) and 6 patients in group 2 (40%) became pregnant. There was also a decrease in LH hormone and the LH:FSH ratio in both the groups (p < 0.01). Conclusions: Rosiglitazone with or without clomiphene changes endocrine markers in PCOS and improves ovulation and pregnancy rate. (J GYNECOL SURG 22:151)
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